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“Gender dysphoria” (GD) is a condition in which a person may feel unhappy with his or her biological sex, express a desire to be the opposite sex, or even insist that he or she is of the opposite sex from what his or her genes and anatomy indicate. People who choose to adopt a “gender identity” different from their biological sex are known as “transgender.”

This condition is increasingly being identified not merely in adults, but even in very young, pre-pubescent children. The American College of Pediatricians (an organization formed as an alternative to the larger and more liberal American Academy of Pediatrics), has now released an important paper on “Gender Dysphoria in Children.” It provides a significant medical and scientific counterweight to the growing ideology that demands affirmation of “transgender” identities—even in children.

I encourage those interested to read the College’s press release and the full study. For those wanting a brief summary, however, here are five key points I took away from the paper.

1) There is no scientific evidence that people with gender dysphoria are “born in the wrong body.”

Those who identify as transgender often claim that they are “women born in men’s bodies” or “men born in women’s bodies.” Yet the scientific evidence put forward in support of this theory is weak. In fact, studies of twins have shown that when one twin identifies as transgender, only 20% of the time does the other twin also identify as transgender. This finding alone disproves the idea that gender dysphoria results primarily from prenatal genetic or hormonal influences. (Note: “gender dysphoria” is not the same as biological “disorders of sexual development”—DSD—or “intersex” conditions. The vast majority of people who identify as transgender are entirely normal males or females genetically and biologically.)

2) Most children who experience gender dysphoria do not grow up to identify as transgender adults.

Research has shown that, left to themselves—that is, if they are not given special hormone treatments and not permitted to “transition” into living socially as a person of the opposite sex—most children who exhibit symptoms of “gender dysphoria” will resolve those issues before adulthood and will live as normal males or females with a “gender identity” that corresponds to (rather than conflicts with) their biological sex at birth. Historically, this has been true of between 80% and 95% of gender dysphoric children.

3) Despite #2, many children with gender dysphoria are now being funneled into a treatment protocol that involves both early and ongoing hormone treatments.

It is one thing (and radical enough) for someone born a boy to be allowed to start living as a girl, or vice versa (that is, to “socially transition”). However, some children (as young as 11) are actually being given hormones to block the natural effects of puberty before it begins. The physical differences between male and female children (when clothed) are relatively small and fairly easy to conceal with clothing. Those differences become greater after puberty, which in turn makes it more difficult for a teenager who identifies as transgender to “pass” as a member of the opposite biological sex. Puberty blockers are intended to forestall that “problem.”

Then when they are older (although sometimes as young as 16), they may begin to receive “cross-sex hormones” (e.g., estrogen for males who identify as female, or testosterone for females who identify as male). These continue the suppression of characteristics of their biological sex, while triggering some of the characteristics of the intended gender (such as breast growth or development of facial hair).

4) Such hormone treatments may have serious negative health consequences—both known and unknown.

Supporters of puberty-blocking hormones contend that their effects are reversible, giving a child the opportunity to change his or her mind about gender “transition” upon reaching adulthood. Case studies show, however, that in reality such an intervention puts the child on a nearly inevitable path to a transgender identity—in sharp contrast to most gender dysphoric children who are not so treated. Completion of the entire protocol of both puberty-blocking and cross-sex hormones (especially when followed by sex reassignment surgery) results in permanent sterility—the inability to ever have biological children, even using artificial reproductive technology. The American College of Pediatricians argues, “The treatment of GD in childhood with hormones effectively amounts to mass experimentation on, and sterilization of, youth who are cognitively incapable of providing informed consent.”

As for cross-sex hormones, a comprehensive review of the scientific literature found, “There are potentially long-term safety risks associated with hormone therapy, but none have been proven or conclusively ruled out.” For example, giving estrogen to biological males may place them at risk for cardiovascular disease, elevated blood pressure, gall bladder disease, and breast cancer; while giving testosterone to biological females may be associated with elevated triglycerides, sleep apnea, and insulin resistance—in addition to the risks associated with obtaining a double mastectomy, which some may do when only 16 years old.

5) Research shows that “severe psychopathology and developmental difficulties” often precede the development of gender dysphoria.

A more compassionate approach to caring for children with gender dysphoria would involve what was once the “standard approach”—either “watchful waiting” or psychotherapy “to address familial pathology if it was present, treat any psychosocial morbidities in the child, and aid the child in aligning gender identity with biological sex.” Children are in no position to given meaningful “informed consent” for more serious and potentially hazardous procedures such as hormone therapy.

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